Epidemiological Profile and Social Welfare Index as Factors Associated with COVID-19 Hospitalization and Severity in Mexico City: A Retrospective Analysis

Mario Antonio Téllez-González, Juan Antonio Pineda-Juárez, Juan Antonio Suárez-Cuenca, Mónica Escamilla-Tilch, Daniel Santillán-Cortez, Silvia García, Sofía Lizeth Alcaraz-Estrada (), Juan Carlos Pérez-Razo, Carlos Alberto Delgado-Quintana, Joel Vargas-Hernández, Sandra Muñoz-López, Maricela Escarela-Serrano, Maribel Santosbeña-Lagunes, Alejandro Alanís-Vega, Ricardo Platón Vázquez-Alvarado, José Alfredo Merino-Rajme and Paul Mondragón-Terán ()
Additional contact information
Mario Antonio Téllez-González: Centro Médico Nacional “20 de Noviembre”, Coordination of Research, Mexico City 03229, Mexico
Juan Antonio Pineda-Juárez: Centro Médico Nacional “20 de Noviembre”, Coordination of Research, Mexico City 03229, Mexico
Juan Antonio Suárez-Cuenca: Centro Médico Nacional “20 de Noviembre”, Clinical Research Service, Mexico City 03229, Mexico
Mónica Escamilla-Tilch: Centro Médico Nacional “20 de Noviembre”, Coordination of Research, Mexico City 03229, Mexico
Daniel Santillán-Cortez: Centro Médico Nacional “20 de Noviembre”, Coordination of Research, Mexico City 03229, Mexico
Silvia García: Centro Médico Nacional “20 de Noviembre”, Clinical Research Service, Mexico City 03229, Mexico
Sofía Lizeth Alcaraz-Estrada: Centro Médico Nacional “20 de Noviembre”, Genomics Research Division, Mexico City 03229, Mexico
Juan Carlos Pérez-Razo: Centro Médico Nacional “20 de Noviembre”, Genomics Research Division, Mexico City 03229, Mexico
Carlos Alberto Delgado-Quintana: Centro Médico Nacional “20 de Noviembre”, COVID-19 Group, Mexico City 03229, Mexico
Joel Vargas-Hernández: Centro Médico Nacional “20 de Noviembre”, COVID-19 Group, Mexico City 03229, Mexico
Sandra Muñoz-López: Centro Médico Nacional “20 de Noviembre”, COVID-19 Group, Mexico City 03229, Mexico
Maricela Escarela-Serrano: Centro Médico Nacional “20 de Noviembre”, COVID-19 Group, Mexico City 03229, Mexico
Maribel Santosbeña-Lagunes: Centro Médico Nacional “20 de Noviembre”, COVID-19 Group, Mexico City 03229, Mexico
Alejandro Alanís-Vega: Centro Médico Nacional “20 de Noviembre”, COVID-19 Group, Mexico City 03229, Mexico
Ricardo Platón Vázquez-Alvarado: Centro Médico Nacional “20 de Noviembre”, COVID-19 Group, Mexico City 03229, Mexico
José Alfredo Merino-Rajme: Centro Médico Nacional “20 de Noviembre”, COVID-19 Group, Mexico City 03229, Mexico
Paul Mondragón-Terán: Centro Médico Nacional “20 de Noviembre”, Coordination of Research, Mexico City 03229, Mexico

IJERPH, 2022, vol. 19, issue 22, 1-13

Abstract: Epidemiological data indicate that Mexico holds the 19th place in cumulative cases (5506.53 per 100,000 inhabitants) of COVID-19 and the 5th place in cumulative deaths (256.14 per 100,000 inhabitants) globally and holds the 4th and 3rd place in cumulative cases and deaths in the Americas region, respectively, with Mexico City being the most affected area. Several modifiable and non-modifiable risk factors have been linked to a poor clinical outcome in COVID-19 infection; however, whether socioeconomic and welfare factors are associated with clinical outcome has been scanty addressed. This study tried to investigate the association of Social Welfare Index (SWI) with hospitalization and severity due to COVID-19. A retrospective analysis was conducted at the Centro Médico Nacional “20 de Noviembre”—ISSSTE, based in Mexico City, Mexico. A total of 3963 patients with confirmed or suspected COVID-19, registered from March to July 2020, were included, retrieved information from the Virology Analysis and Reference Unit Database. Demographic, symptoms and clinical data were analyzed, as well as the SWI, a multidimensional parameter based on living and household conditions. An adjusted binary logistic regression model was performed in order to compare the outcomes of hospitalization, mechanical ventilation requirement (MVR) and mortality between SWI categories: Very high (VHi), high (Hi), medium (M) and low (L). The main findings show that lower SWI were independently associated with higher probability for hospital entry: VHi vs. Hi vs. M vs. L-SWI (0 vs. +0.24 [OR = 1.24, CI 95% 1.01–1.53] vs. +0.90 [OR = 1.90, CI 95% 1.56–2.32] vs. 0.73 [OR = 1.73, CI 95% 1.36–2.19], respectively); Mechanical Ventilation Requirement: VHi vs. M vs. L-SWI (0 vs. +0.45 [OR = 1.45, CI 95% 1.11–1.87] vs. +0.35 [OR = 1.35, CI 95% 1.00–1.82]) and mortality: VHi vs. Hi vs. M (0 vs. +0.54 [OR = 1.54, CI 95% 1.22–1.94] vs. +0.41 [OR = 1.41, CI 95% 1.13–1.76]). We concluded that SWI was independently associated with the poor clinical outcomes in COVID-19, beyond demographic, epidemiological and clinical characteristics.

Keywords: COVID-19; social welfare; healthcare disparities; socioeconomic factors; Mexico (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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